Graduated: 2004
NPI: 1407090897
Practice Locations (2)
ENLIVEN RESOURCES LLC
929 HARRISON AVE
COLUMBUS, OH 432151300
6149404868
OH INDEPENDENT MEDICAL GROUP LLC
929 HARRISON AVE, SUITE 200
COLUMBUS, OH 432151300
6149404868
Source: CMS National Downloadable File, September 2026.